Health Economics Commons^™

Retiree Health Benefits As Deferred Compensation: Evidence From The Health And Retirement Study, James Marton, Stephen A. Woodbury

Upjohn Institute Working Papers

Are early retiree health benefits (RHBs) a form of deferred compensation that binds workers to an employer? Most employers who offer RHBs offer them only to workers who have 10 or more years of tenure with the firm and have reached age 55. Accordingly, workers in firms offering RHBs have an incentive to stay with a firm in the years before they attain eligibility for RHBs, and a greater incentive than otherwise to retire thereafter. We test for the existence of such a pattern of incentives by examining the age-specific relationship between workers’ eligibility for RHBs and retirement. The findings …

Estimating Medical Cost Offsets Attributable To Public Health Spending, Glen P. Mays

Health Management and Policy Presentations

Uncertainty about the magnitude and timing of economic returns associated with spending on public health services has contributed to policy debates about the optimal role of the federal government in financing these services.

Public Health Spending, Preventable Outcomes, And Medical Cost Offsets: Questions For Health Reform, Glen P. Mays

Health Management and Policy Presentations

Uncertainty continues to surround the health and economic effects that can be expected from increased federal spending on public health and prevention strategies. Recent research provides some insight into the question of whether spending on public health strategies can offset the need for future spending on medical care.

Finding The Medicine For Healthcare, Knowledge@Smu

Knowledge@SMU

Health care costs are escalating rapidly in countries with aging populations and is often a source of headache for policymakers. Singapore, which has one of the world’s acclaimed healthcare systems, also faces the same issues of balancing social and economic objectives in its healthcare system. A healthcare expert has now proposed a radical policy shift for the Republic to meet the medical needs of its citizens.

When To Say “I Love You”: Before Or After Sex?, Knowledge@Smu

Knowledge@SMU

There are no hard and fast rules on when one should say 'I love you', or who should say it first. Yet, the implications either way can be profound. Taking an evolutionary-economics perspective, these words, for men, could be taken as "bids for sexual access". Women, on the other hand, might view it differently, depending on whether the words were uttered before or after sex. SMU associate professor Norman Li examines what it is that romantic partners really mean when they say "love".

Health Insurance Exchanges: A Panacea Or A Band-Aid?, Luisa Sanchez De Tagle

Electronic Theses and Dissertations

In 2010, the 111th Congress passed the first national health care reform in the United States, the Patient Protection and Affordable Care Act (ACA). This landmark legislation is intended to "fix" a health care system renowned for decreasing access and escalating costs. This paper examines one of the principal reforms in the ACA, the state health insurance exchanges. The author finds theoretical and empirical evidence to support the exchanges' potential (in conjunction with other relevant ACA reforms) to increase access, decrease insurers' excess profits and shift health care costs away from those least able to afford them. The exchanges fall …

One Fish, Two Fish, Red Fish, Blue Fish: Effects Of Price Frames, Brand Names, And Choice Set Size In Medicare Part D Insurance Plan Decisions, Andrew J. Barnes, Yaniv Hanoch, Stacey Wood, Pi-Ju Liu, Thomas Rice

Health Policy Publications

Because many seniors choose Medicare Part D plans offering poorer coverage at greater cost, the authors examined the effect of price frames, brand names, and choice set size on participants' ability to choose the lowest cost plan. A 2×2×2 within-subjects design was used with 126 participants aged 18 to 91 years old. Mouselab, a web-based program, allowed participants to choose drug plans across eight trials that varied using numeric or symbolic prices, real or fictitious drug plan names, and three or nine drug plan options. Results from the multilevel models suggest numeric versus symbolic prices decreased the likelihood of choosing …

Who Is Covered And Who Under-Reports: An Empirical Analysis Of Access To Social Insurance On The Egyptian Labor Market, Rania Roushdy, Irene Selwaness

Poverty, Gender, and Youth

This working paper investigates the dynamics and determinants of having access to social insurance coverage on the Egyptian labor market among wage and non-wage workers. The results show that men, older, married, better educated, and white collar highly skilled workers are more likely to have social insurance coverage. Access to social insurance is more likely to exist in the public sector and in large private enterprises. Furthermore, acquiring social insurance coverage in the private wage work sector does not often come at first entry; but it takes some time to gain such access. In contrast, experience is not important for …

Social Protection In Egypt: A Policy Overview, Maia Sieverding, Irene Selwaness

Poverty, Gender, and Youth

The need to address the shortcomings of Egypt’s current social protection system as part of a broader process of developing a new social contract between the Egyptian government and its citizens has been noted for a number of years. With a new government recently put in place, Egypt is now at a potential turning point in terms of implementing unfinished reforms to the system or proposing alternative ones. The aim of this paper is therefore to provide an overview and assessment of current public social protection mechanisms and suggest directions for new policy measures. The social and health insurance systems …

Three Essays On The Health Insurance Coverage Of Young Adults, David M. Yaskewich

Theses and Dissertations--Economics

This dissertation examines the health insurance status of young adults during the transition to adulthood. In a series of three essays, I analyze what happens as young adults reach important milestones and the effects of public policies. The first essay is a descriptive study on how insurance status changes after reaching age 19 and graduating from college. The likelihood of becoming uninsured rises sharply once turning age 19 and then peaks at age 23. While the proportion uninsured also increases following college graduation, this increase disappears after one year. The second essay analyzes the effect of a dependent age law …

Marketing Pharmaceuticals: A Constitutional Right To Sell Prescriber-Identified Data?, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

Pharmaceutical companies have strong economic interests in influencing physician-prescribing behaviors. They advertise direct-to-the-consumer and to the physician. Beyond general marketing, manufacturers promote their drugs to physicians through “detailing”—sales representatives (“detailers”) visiting medical offices to persuade physicians to prescribe their products.

By law, pharmacies receive specific information with every prescription, including the physician’s name, the drug, and the dose. Pharmacies sell these records to Prescription Drug Intermediaries (data miners), who use advanced computing to analyze prescriber-identified information (which physicians prescribe what drugs, in what dose, and with what prescribing patterns). Data miners, in turn, lease sophisticated reports to pharmaceutical companies to …

A System Dynamics Model For Simulating Ambulatory Health Care Demands, Rafael Diaz, Joshua G. Behr, Mandar Tulpule

VMASC Publications

Introduction: This article demonstrates the utility of the system dynamics approach to model and simulate US demand for ambulatory health care service both for the general population and for specific cohort subpopulations over the 5-year period, from 2003 to 2008. A system dynamics approach that is shown to meaningfully project demand for services has implications for health resource planning and for generating knowledge that is critical to assessing interventions.

Methods: The study uses a cohort-component method in combination with structural modeling to simulate ambulatory health care utilization. Data are drawn from the National Ambulatory Medical Care Survey and the National …

Formal And Informal Care: An Empirical Bayesian Analysis Using The Two-Part Model, Juan Du

Economics Faculty Publications

Informal care provided to the elderly by their children is proposed as a less expensive alternative to institutional long-term care. This paper explores how the elderly's consumption of medical care changes in response to changes in the informal care they receive from their children. Many earlier studies have ignored both the endogeneity of informal care and the complicated nature of health care utilization data. This paper develops a two-part model with informal care treated as an endogenous regressor and imposes exclusion restrictions on the selection process. The model is fitted using the Bayesian Markov Chain Monte Carlo (MCMC) methods, in …

The Health And Wealth Of A Nation: Employer-Based Health Insurance And The Affordable Care Act, Nan L. Maxwell

Upjohn Press

This research examines the behaviors of firms with respect to their provision of health care prior to the Affordable Care Act (ACA) deliberations and uses those behaviors to assess changes in employer-sponsored health insurance that might occur once the ACA is fully implemented.

Differential Effects Of Tort Reform Across Medical Specialties, William C. Dodds

CMC Senior Theses

This paper utilizes data on physician malpractice insurance premiums and state tort law to analyze how physicians in various medical specialties are differentially affected by caps on noneconomic damages. As higher premiums put pressure on legislators to enact damage caps, I instrument caps on noneconomic damages with enactment of tort reform measures that do not affect malpractice premiums to uncover the effect of caps on noneconomic damages on such premiums. I find evidence to support that, in terms of dollars saved, physicians in high risk specialties benefit more from noneconomic damage caps than physicians in low risk specialties. However, in …

Driving Qi With Research: Findings From Public Health Pbrns, Glen P. Mays

Health Management and Policy Presentations

Public health agencies are increasingly experimenting with quality improvement (QI) strategies designed to enhance the effectiveness and efficiency of their efforts. Does QI work in public health, and if so for whom and under what circumstances? What QI strategies work best for which types of public health process failures, and at what cost? Research underway through the Public Health Practice-Based Research Networks (PBRN) Program is examining these types of questions to build an evidence base for public health QI.

The Science Of Public Health Delivery: Evidence, Uncertainties & Research Needs, Glen P. Mays

Health Management and Policy Presentations

Policy initiatives to reform the nation's health system increasingly recognize the need to incorporate public health and prevention strategies. The nation's delivery system for public health, however, varies widely across states and communities in its structure, authority, and capabilities. This session examines research from the growing field of public health services and systems research to identify directions for improving public health delivery.

Estimating The Value Of Public Health Services & Systems: Evidence, Uncertainties, And Research Needs, Glen P. Mays

Health Management and Policy Presentations

The Affordable Care Act authorized the largest expansion in federal funding for public health services and delivery systems in decades. These provisions, designed to support programs and services that promote health and prevent disease and injury on a population-wide basis, remain controversial because of uncertainties regarding their effectiveness in improving health and constraining medical cost growth. This session examines a series of recent studies to shed light on the health and economic value of spending on public health.

Disparities Research In Public Health Pbrns, Glen P. Mays

Health Management and Policy Presentations

Public health agencies are well positioned within the health system to play key roles in addressing oral health issues on a population-wide basis, However, current evidence reveals wide geographic variation in the delivery of public health interventions for oral health promotion. This session explores the factors contributing to this variation, and it highlights studies underway through the Public Health Practice-Based Research Networks (PBRNs) to produce more and better evidence about public health delivery and impact.

Poor Women With Sexually Transmitted Infections: Providers’ Perspectives On Diagnoses, Genevieve R. Cox

Sociology

This article presents results from a study of health care providers, mainly nurses and nurse practitioners, who routinely diagnose sexually transmitted diseases (STDs) in rural low-income populations in West Virginia (WV). A qualitative analysis of eighteen semi-structured interviews reveals that providers who consistently work with low-income populations believe patients undergo a negative change in self-image in response to a chronic STD diagnosis. Providers express concerns about a number of issues related to low-income, rural women’s access to sexual health care and see the need for more sexuality education, more funding for free and reduced cost clinics, and more available health …